Serum steroid and sex hormone-binding globulin concentrations and the risk of incident benign prostatic hyperplasia: results from the prostate cancer prevention trial.
The authors conducted a nested case-control study of serum steroid concentrations and risk of benign prostatic hyperplasia (BPH), using data from the placebo arm of the Prostate Cancer Prevention Trial (1993-2003). Incident BPH over 7 years (n = 708) was defined as receipt of treatment, a report of 2 International Prostate Symptom Score (IPSS) values greater than 14, or 2 increases of 5 or more from baseline IPSS values with at least 1 value greater than or equal to 12. Controls (n = 709) were selected from men who reported no BPH treatment or any IPSS greater than 7. Baseline serum was analyzed for testosterone, estradiol, estrone, 5alpha-androstane-3alpha, 17beta-diol-glucuronide, and sex hormone-binding globulin. Covariate-adjusted odds ratios contrasting the highest quartiles with the lowest quartiles of testosterone, estradiol, and testosterone:17beta-diol-glucuronide ratio were 0.64 (95% confidence interval (CI): 0.43, 0.95; P(trend) = 0.04), 0.72 (95% CI: 0.53, 0.98; P(trend) = 0.09), and 0.64 (95% CI: 0.46, 0.89; P(trend) = 0.004), respectively. Findings did not differ by age, body mass index, time to BPH endpoint, or type of BPH endpoint. High testosterone levels, estradiol levels, and testosterone:17beta-diol-glucuronide ratio are associated with reduced BPH risk, which may reflect decreased activity of 5-alpha-reductase. Genetic or environmental factors that affect the activity of 5-alpha-reductase may be important in the development of symptomatic BPH.
Kristal
Alan R
AR
Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, M4-B402, PO Box 19024, Seattle, WA 98109-1024, USA. akristal@fhcrc.org
Schenk
Jeannette M
JM
Song
YoonJu
Y
Arnold
Kathryn B
KB
Neuhouser
Marian L
ML
Goodman
Phyllis J
PJ
Lin
Daniel W
DW
Stanczyk
Frank Z
FZ
Thompson
Ian M
IM
D000368:Aged; D018120:Finasteride / Q000627:therapeutic use*; D005500:Follow-Up Studies; D012739:Gonadal Steroid Hormones / Q000097:blood*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D011470:Prostatic Hyperplasia / Q000097:blood* / Q000150:complications / Q000453:epidemiology; D011471:Prostatic Neoplasms / Q000097:blood / Q000453:epidemiology / Q000517:prevention & control*; D012189:Retrospective Studies; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism*; D011795:Surveys and Questionnaires; D013997:Time Factors; D014481:United States / Q000453:epidemiology
D012739:Gonadal Steroid Hormones; D012738:Sex Hormone-Binding Globulin; D018120:Finasteride